title: Intraoperative hyperthermic intraperitoneal chemotherapy as adjuvant chemotherapy for advanced gastric cancer patients with serosal invasion.
abstract: BACKGROUND
  To evaluate hyperthermic intraperitoneal chemotherapy (HIPEC) as an adjuvant chemotherapy in advanced gastric cancer (AGC) patients with serosal invasion.
  
  
  METHODS
  Patients who received radical surgery and palliative surgery between January 2002 and December 2010 were retrospectively examined. Patients were divided into two groups, namely, one group that underwent surgery and another group that underwent surgery with HIPEC. All patients who received HIPEC had suspected serosal invasion on an abdominal computed tomography or by the surgeon's assessment during the operation.
  
  
  RESULTS
  The prophylactic groups included 83 patients who underwent gastrectomy alone. A total of 29 patients underwent gastrectomy with HIPEC. The 5-year survival rates were 10.7% and 43.9%, respectively. The 5-year mean survival times were 22.66 (17.55-25.78) and 34.81 (24.97-44.66) months (p = 0.029), respectively. There were 52 patients who had a recurrence of carcinomatosis among 133 patients who had resections (52/133, 39.1%). The 3-year disease-free survival rate for carcinomatosis was 28.87% in the group that received surgery alone, whereas it was 66.03% in the group that received HIPEC. There was no significant difference in the rate of complication between the two groups in the prophylactic group (p = 0.542). Thus, curative surgery with HIPEC had a better prognosis for AGC with serosal invasion. The carcinomatosis recurrence time was longer in patients who underwent gastrectomy with HIPEC and received R0 resection.
  
  
  CONCLUSIONS
  The survival benefit of HIPEC as an adjuvant therapy for gastric cancer patients with serosal invasion should be validated in a large cohort.
authors.affiliation: Division of General Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC.
authors.forename: Lung-Yun
authors.initials: LY
authors.lastname: Kang
authors.forename: King-Tong
authors.initials: KT
authors.lastname: Mok
authors.forename: Shiuh-Inn
authors.initials: SI
authors.lastname: Liu
authors.forename: Cheng-Chong
authors.initials: CC
authors.lastname: Tsai
authors.forename: Being-Whey
authors.initials: BW
authors.lastname: Wang
authors.forename: I-Shu
authors.initials: IS
authors.lastname: Chen
authors.forename: Yu-Chia
authors.initials: YC
authors.lastname: Chen
authors.forename: Bo-Min
authors.initials: BM
authors.lastname: Chang
authors.forename: Nan-Hua
authors.initials: NH
authors.lastname: Chou
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D007274:Injections, Intraperitoneal; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents
keywords: adjuvant chemotherapy; intraperitoneal chemotherapy; serosal invasion; stomach neoplasm